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Smoking Kills: Experimental Proof from the Lung Health Study

Jonathan M. Samet, MD, MS
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From Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Jonathan M. Samet, MD, MS, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Room W6041, Baltimore, MD 21205; e-mail, jsamet@jhsph.edu.

Ann Intern Med. 2005;142(4):299-301. doi:10.7326/0003-4819-142-4-200502150-00012
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In 1938, Raymond Pearl reported in Science that tobacco smoking shortened the life span (1). In a study of determinants of longevity in East Baltimore families, he developed life tables for smokers and nonsmokers, using data from 6813 men, most of whom were smokers. Pearl showed that life span after age 30 years for white men was reduced by about 10 years in “heavy smokers” compared with nonsmokers (Figure). Longevity was also lower for “moderate smokers.” In retrospect, this powerful observation received surprisingly little attention, even though an effect of this magnitude on total mortality, a crude but integrating measure of population health, must have come from strong increments in risk for death from specific diseases. George Seldes, an investigative reporter who championed tobacco control, attributed the limited media coverage of the finding to the influence of the tobacco industry (2).


smoking ; lung

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The survivorship lines of life tables for white males falling into three categories relative to the usage of tobacco.

A. Non-users (solid line ); B. Moderate smokers (dash line ); C. Heavy smokers (dotline ). Originally published in Science. 1938;87:216-7.

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